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Many DNIs are mutualfor instance, the drug affects micronutritional status, and the micronutrient affects drug metabolism, contributing to adverse drug effects (Figure 1) [28,29,30]

The mechanism of IL-4 inhibition is thought to inhibit the binding of NF-B and transcription factor Sp-1 with binding sites of the IL-4 promoter region (Mabalirajan et al., 2009)

Int Rev Cytol 1981, 68: 251305

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As a result, there may be a notable rise in MTX-related toxicities due to prolonged, persistent, or elevated MTX plasma levels